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End of Life Care in the Intensive Care Unit

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End-of-Life Care in Cardiovascular Disease

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Abstract

One in five Americans die in or directly following an ICU stay. Predicting who will survive the ICU is difficult and those who do survive struggle with post-ICU physical and psychological symptoms and functional and cognitive impairments. All patients, regardless of prognosis, benefit from a multidisciplinary, patient- and family-centered approach to care aimed at assessing and treating multiple sources of suffering. Research highlights potential areas for improvement in EOL care in the ICU. Measures of quality ICU palliative care and models for integrating palliative care into the ICU are reviewed. Skillful clinician communication is necessary to facilitate shared decision-making, provide care that is concordant with patients’ values, and support patients facing serious life threatening illness and their families. Decision making and best practices for forgoing life sustaining treatment in the ICU are reviewed.

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Authors and Affiliations

  1. Division of Critical Care Medicine, Department of Medicine, Montefiore Medical Center, Bronx, NY, USA

    Aluko A. Hope MD, MSCE

  2. Divisions of Geriatrics and Cardiology, Department of Medicine and The Montefiore Einstein Center for Bioethics, Montefiore Medical Center, 111 E. 210th Street, Bronx, NY, 10467, USA

    Hannah I. Lipman MD, MS

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  1. Aluko A. Hope MD, MSCE
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  2. Hannah I. Lipman MD, MS
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Correspondence to Hannah I. Lipman MD, MS .

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Editors and Affiliations

  1. Portland VA Medical Center,, Patient-Centered Education and Research, Salt Lake City, UT, USA, Portland, Oregon, USA

    Sarah J. Goodlin

  2. Washington University School of Medicine, St Louis, Missouri, USA

    Michael W. Rich

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Hope, A.A., Lipman, H.I. (2015). End of Life Care in the Intensive Care Unit. In: Goodlin, S., Rich, M. (eds) End-of-Life Care in Cardiovascular Disease. Springer, London. https://doi.org/10.1007/978-1-4471-6521-7_5

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